Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disease with a lifetime risk of 1 in 400 for a young adult (Armon 2007). The average life expectancy of a person with ALS is two to five years from time of diagnosis with 5,600 new cases diagnosed per year. Incidence rates vary in industrialized nations (an annual incidence rate of 0.2 to 2.4 per 100,000 population), to that in developing countries (1.5-2.0 per 100,000 per year). Evidence has shown potential linkages between cyanobacteria and ALS clusters (Bradley et al. 2013). Cyanobacteria are ubiquitous throughout all ecosystems and are particularly noxious when anthropogenic eutrophication of water-bodies causes large concentrations to form blooms. Cyanobacteria are well-known to produce acute and chronic toxins that have human health implications. A primary obstacle in advancing our understanding of linkages between cyanobacteria blooms, toxicity, and ALS is a lack of information on the presence, extent, magnitude, and intensity of harmful algal blooms (HABs) and water quality in water bodies. Goal: The innovation of this NIH SBIR Phase II is the development of operational water quality and cyanobacteria risk maps that utilize multiscale satellite remote sensing platforms to drive an eco- epidemiological model for evaluating linkages between water quality and ALS. Approach: We will apply operational band ratio and shape filter algorithms to multiscale satellite remote sensing data. We will utilize Landsat, MERIS, and MODIS to have scaled approach. Spatial regression, clustering, and advanced geostatistics will be employed to build an eco-epidemiological model to map ALS risk factors and characterize the relationship between water quality and ALS cases. Expected Outcomes 1. Operational lake cyanobacteria and water quality exposure maps and risk metrics 2. Development of eco-epidemiological modeling framework for evaluating linkages between water quality and ALS. Phase II will develop model for three unique and diverse case studies for public health agencies in California, New England, and Florida. 3. Build and operate state-of-the-art lake water quality and health risk web mapping services and mobile app for all lakes >8 hectares in Phase II study areas for end users using open source technology.